{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:27:33Z","timestamp":1793136453569,"version":"4.5.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Anxiety disorders are among the most common mental health problems experienced by adolescents worldwide because of their evident significant impact on their quality of life and functioning. The generalized anxiety disorder item (GAD-7) was manufactured to identify the severity of self-reported anxiety symptoms. Efforts to address and screen for mental health problems in Rwanda have been limited, and the importance of screening for anxiety disorders is high. The primary aim of this study was to analyze the psychometric properties of the Kinyarwanda version of the Generalized Anxiety Disorder GAD-7, and then test the measurement invariance of the GAD-7 by gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used the Rwandese version of GAD-7 among secondary school students in Kigali city (n=1813). Measurement invariance of the GAD-7 across gender and report on anxiety symptom severity prevalence. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine measurement invariance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our findings demonstrated that in the sample of 1813 adolescents aged between 12 and 17 years, generalized anxiety symptoms prevalence rates were higher in females (46.4%) than males (n= 29.8%) GAD-7 demonstrated good reliability and validity coefficients with a Cronbach\u2019s \u03b1 of .077 and KMO and Bartlett test of Sphericity = 0.835. In addition to these psychometric properties, the GAD-7 screening scale had equivalence for configural and metric invariance across groups with excellent fit indices, and we confirmed partial scalar invariance across groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The GAD-7 can be used in cross-group comparison of generalized anxiety disorder prevalence, and we acknowledge that full scalar invariance is generally difficult to confirm, especially due to gender differences. We recommend that future studies further investigate populations living in rural areas and conduct trials that will focus on anxiety-specific treatment in Rwandan Clinical health care centers to determine the diagnostic accuracy of this screening tool. <\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1346267","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T13:15:48Z","timestamp":1710162948000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Assessing anxiety symptom severity in Rwandese adolescents: cross-gender measurement invariance of GAD-7"],"prefix":"10.3389","volume":"15","author":[{"given":"Lisa Cynthia","family":"Niwenahisemo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60827-1","article-title":"Child and adolescent mental health worldwide: evidence for action","volume":"378","author":"Kieling","year":"2011","journal-title":"Lancet (London England)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s0005-7967(98)00179-x","article-title":"Frequency and comorbidity of social phobia and social fears in adolescents","volume":"37","author":"Essau","year":"1999","journal-title":"Behav Res Ther"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e31803062bf","article-title":"Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use","volume":"46","author":"Heiervang","year":"2007","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1017\/S003329171200147X","article-title":"Global prevalence of anxiety disorders: a systematic review and meta-regression","volume":"43","author":"Baxter","year":"2013","journal-title":"Psychol Med"},{"key":"B5","doi-asserted-by":"crossref","DOI":"10.1097\/NMD.0b013e3182a2168a","article-title":"Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility","volume":"201","author":"First","year":"2013","journal-title":"J Nerv Ment Dis"},{"key":"B6","article-title":"Disease and mortality in sub-saharan africa","author":"Jamison","year":"2006","journal-title":"Popul Assoc Am Meet"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006778","article-title":"Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide","volume":"5","author":"Rugema","year":"2015","journal-title":"BMJ Open"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-200209000-00009","article-title":"Prevalence of depression in rural Rwanda based on symptom and functional criteria","volume":"190","author":"Bolton","year":"2002","journal-title":"J Nerv Ment Dis"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21728","article-title":"Mental health 15 years after the killings in Rwanda: imprisoned perpetrators of the genocide against the Tutsi versus a community sample of survivors","volume":"25","author":"Schaal","year":"2012","journal-title":"J Trauma Stress"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1037\/a0035240","article-title":"Posttraumatic stress reactions among Rwandan youth in the second year after the genocide: Rising trajectory among girls","volume":"6","author":"Neugebauer","year":"2014","journal-title":"Psychol Trauma Theory Res Pract Policy"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/1752-4458-8-12","article-title":"Transgenerational consequences of PTSD: risk factors for the mental health of children whose mothers have been exposed to the Rwandan genocide","volume":"8","author":"Roth","year":"2014","journal-title":"Int J Ment Health Syst"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14165-x","article-title":"Prevalence of mental disorders, associated co-morbidities, health care knowledge and service utilization in Rwanda - 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